Help Select our Next Physician-Focused Financial Planning Textbook Cover

 Certified Medical Planner   

TRANSFORMATIONAL FINANCIAL PLANNING STRATEGIES FOR DOCTORS AND ADVISORS

[Best Practices from Leading Consultants and Certified Medical Planners™]

By Dr. David Edward Marcinko MBA CMP

By Hope Rachel Hetico RN MHA CPHQ, CMP

A Reader Opinion and Voting Poll

David and Hope

Drawing on the expertise of our readers, members and multi-degreed doctors, and multi-certified financial advisors, the text TRANSFORMATIONAL FINANCIAL PLANNING STRATEGIES FOR DOCTORS AND ADVISORS [Best Practices from Leading Consultants and Certified Medical Planners™] will help re-shape the industry landscape for the next-generation of MDs and FAs as the current ecosystem strives to keep pace.

Traditional generic products and sales-driven advice will yield to a new breed of deeply informed financial advisor, or Certified Medical Planner™.  The profession is set to be transformed by “cognitive-disruptors” that will significantly impact the $2.8 trillion healthcare marketplace for those financial consultants serving this challenging sector. There will be winners and losers.

The text which contains 24 chapters, and champions healthcare providers while informing financial advisors, is divided into four sections compete with glossary of terms, CMP™ curriculum content, and related information sources:

  1.  For ALL medical providers and financial industry practitioners
  2. For NEW medical providers and financial industry practitioners
  3. For MID-CAREER medical providers and financial industry practitioners
  4. For MATURE medical providers and financial industry practitioners

The result is a codified “must-have” book, for all health industry participants, and those seeking advice from the growing cadre of financial consultants and Certified Medical Planners™ who seek to “do well – by doing good”, dispensing granular physician-centric financial advice: Omnia pro medicus-clientis.

And so, we now ask our ME-P readers, contributors and subscribers to help us select the cover imprint for this ground-breaking major new textbook. Please select one from the following three options:

OPTION #1

K23315_v1OPTION #2K23315_v2

OPTION #3K23315_v3

 

Deeper Book Info:

For more information on the content, contributors, case models, format and style of this new book, which will advance the re-constructive innovation of the profession; please review this link:

Transformational Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

THE VOTING POLL

RAISING THE BAR

The informed voice of a new generation of fiduciary advisors for healthcare

About Certified Medical Planners

Link: Enter the CMPs

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

 

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Our ME-P Recommended Books Review

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Purchase today and Profit in 2014

By Ann Miller RN MHA

[Executive-Director]

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Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to write a book review or check out our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

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Seeking Securities Analysts, Stock-Brokers and Investment Bankers for New “Financial Planning Textbook for Doctors”

Certified Medical Planner  

Planning our newest major textbook

By Ann Miller RN MHA [ph-770-448-0769]

[Executive-Director]

Dear Stock Brokers, IBs and Securities Analysts,

Greetings from the Institute of Medical Business Advisors, in Atlanta, Georgia.

Historical Review

As you may know, we released: Financial Planning Handbook for Physicians and Advisors, some time ago. It has enjoyed much success and acclaim in the medical and financial service sectors.

Recently, we have been asked to produce the next edition of this book for our target market of physicians, nurses, medical professionals, healthcare administrators – and those in the financial services sector who target this large and fertile, but rapidly changing niche market.

Why Now?

Urgency for the update has been prompted by ARRA, HI-TECH, the flash-crash of 2008 and the day-crash of 2011; by social, macro-economic and demographic changes; by political fiat and especially the PP-ACA.

Our medical colleagues are frustrated, afraid and fearful for their financial futures. They WANT informed advice.

Thus, true integrated financial planning information that targets this market – very expertly and specifically – is greatly needed.

The Invitation 

And so, we ask if you are interested in contributing an updated vision of an existing book chapter.

  • INVESTMENT BANKING-SECURITIES-MARKETS-MARGIN
  • HOSPITAL EMPLOYEE BENEFITS AND STOCK OPTIONS
  • INVESTMENT POLICY STATEMENT CONSTRUCTION

Not to worry – The original MS-WORD® chapter files are archived and available for use. We will forward it to you, upon assignment acceptance.

And, we are again fortunate that our Editor-in-Chief will be Dr. David Edward Marcinko FACFAS MBA CMP™ along with Professor Hope Rachel Hetico RN MHA CMP™ serving as Managing Editor.

They opined at a recent interview for the ME-P.

David and Hope” … We have entered into an emerging era in the financial planning ecosystem. It is a new era where one size does not fit all; and off-the-shelf financial products and mass sales customization is no long adequate for physicians and medical professionals; or their related generic financial planners or wire-house advisors.

It is a period of rapid change, shifting reimbursement paradigms and salary reductions that focus the healthcare industrial complex on pay-for-performance [P4], compensation for value and quality care; rather than procedures performed and quantity of care.

All must learn to do more with less professionally; and plan their personal financial lives more efficiently than ever before. Mistakes will be more difficult to overcome and the wiggle room that high income earning physicians, nurses and medical professionals used to enjoy is being narrowed by demographic, economic, social, technological and political fiat.

This emerging financial planning analog follows the health industry’s fiscal metamorphosis …”

Style Instructions 

The look and feel, format and style, and font and size of the book will remain the same. We use endnotes, not foot notes; and include mini-case reports or illustrative case models. It will be a major text; not a handbook.

Timeline for submission is about 3 months. Additional time is available, if needed, for a comprehensive update. But, we are trying to avoid running too far along into 2014 in order to avoid income tax season and the related time constraints on all concerned.

Writers Search

A Pleasure – Not Burden 

This should be a pleasurable project for you; and not anxiety provoking.

So, if you are a medically focused and experienced financial advisor with an: MBA, CFP®, PhD, MD, DDS, MSA/MS, CPA, RN, CMP®, DO, JD and/or CFA degree or designation, etc; please let me know if you are interested in updating and revising our chapters. OR, authoring a new to the world chapter.

Your Payback 

In return for your conscientious industry, you will receive a complimentary edition of the entire textbook; be listed on this ME-P as thought-leader with related book advertising content attributed to you; and given e-exposure to our almost 600,000 readers and ME-P subscribers …. Such the deal!

And, you will be added to our roster of experts for potential referrals, interviews, pod-casts and other marketing efforts

Assessment

Regardless of your decision, we remain apostles promoting your core vision of physician focused financial planning whenever possible.

Or, you may suggest another possible author- writer-expert contributor; if you wish.

Just let me know; ASAP [MarcinkoAdvisors@msn.com]

Thank you.
ANN
ANN MILLER RN MHA
[Executive-Director]
INSTITUTE OF MEDICAL BUSINESS ADVISORS, INC.
Suite #5901 Wilbanks Drive
Norcross, Georgia, 30092-1141 USA
[Ph] 770.448.0769

DICTIONARIES: http://www.springerpub.com/Search/marcinko
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
BLOG: www.MedicalExecutivePost.com 

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NOTICE: This invitation is not for all readers of the ME-P. It is a privilege invitation intended for those who possess the needed credentials, as decided by us, with an inclination to serve.  We reserve the right to accept or reject contributors, and content, at our own non-disclosed discretion.

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Modern Office Management Skills for Savvy Physicians

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“Learning” about The Business of Medical Practice in Modernity

By Ann Miller RN MHA

www.BusinessofMedicalPractice.com

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Medical Business Advisors

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LEXICONS: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
BLOG: www.MedicalExecutivePost.com

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Some Modern Issues Impacting Hospital Revenue Cycles

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By Carol S. Miller RN CPM MHA

By Dr. David Edward Marcinko MBA CMP™

Carol S. Miller “Collectively the healthcare industry spends over $350 Billion to submit and process claims while still working with cumbersome workflows, inefficient processes, and a changing landscape marked by increasing out-of-pocket cost for patients as well as increasing operating costs.”

The Norm Continues Downhill

For many years hospitals and healthcare organizations have struggled to maintain and improve their operating margins.  They continue to face a widening gap between their operating costs and the revenues required to cover not only current costs, but also to finance strategic growth initiatives and investments.

Faced with increased operational costs and associated declines in rates of reimbursement, many healthcare hospital executives and leaders are concerned that they will not achieve margin targets.  To stabilize the internal financial issue, some hospital have focused on lowering expenses in order to save costs – an area they control and an area that will show an immediate impact; however, that is not the best solution.

Beware Cost Reductions

Hospital executives are concerned with the effect that these reductions may have on patient quality and service.  Finding ways to maximize workflow to lower operating costs is vital.  Every dollar not collected negatively impacts short- and long term capital projects, lowers patient satisfaction scores and possibly affects quality of patient care.

Status Today

Hospitals, healthcare organizations and all medical providers are under great pressure to collect revenue in order to remain solvent. And so, here are some of the issues impacting the modern hospital revenue cycle as Obama-Care, or the PP-ACA of 2010, is launched next month?

Issues Impacting the Revenue Cycle

Several of the major leading issues facing the revenue cycle are:

  • Impact of Consumer-driven Health – This process has emerged as a new approach to the traditional managed care system, shifting payment flows and introducing new “non-traditional” parties into the claims processing workflow.  As market adoption enters the mainstream, consumer-driven health stands to alter the healthcare landscape more dramatically than anything we have seen since the advent of managed care.  This process places more financial responsibility on the consumer to encourage value-drive healthcare spending decisions.
  • Competing high-priority projects –Hospitals are feeling pressured to maximize collections primarily because they know changes are coming down the pike due to healthcare reform and they know they will need to juggle these major initiatives along with the day-to-day revenue cycle operations.
  • Lack of skilled resources in several areas – Hospital have struggled to find the right personnel with sufficient knowledge of project management, clinical documentation improvement, coding and other revenue cycle functions, resulting in inefficient operations.
  • Narrowing margins – Declines in reimbursement are forcing hospitals to look at their organization to determine if they can increase efficiencies and automate to save money.  Hospitals are faced with the potential of increased cost to upgrade and adapt clinical software while not meeting budget projections.  There are a number of factors contributing to the financial pressure including inefficient administrative processes such as redundant data collection, manual processes, and repetitive rework of claims submissions.  Also included are organizations using outdated processes and legacy technologies.
  • Significant market changes – Regardless of what happens with the Patient Protection and Affordable Care Act, hospitals will have to deal with fluctuating amounts of insured and uninsured patients and variable payments.
  • Limited access to capital – With the trend towards more complex and expensive systems, industry may not have the internal resources and funding to build and manage these systems that keep pace with the trends.
  • Need to optimize revenue – There are five core areas hospitals have to examine carefully and they are:
    • ICD-10 – This is an entirely new coding and health information technology issue but is also a revenue issues
    • System integration – Hospitals need to look at integrating software and hardware systems that can combine patient account billing, collections and electronic health records.
    • Clinical documentation – Meaningful use will require detailed documentation in order for payment to be made and this is another revenue issue.
    • Billing and claims management – Reducing denials and reject claims, training staff, improving point-of-service collections and decreasing delays in patient billing can improve the revenue cycle productivity,
    • Contract analysis – Hospitals need to focus more on negotiating rates with insurers in order to increase revenue.

Hospital

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Hospitals: http://www.crcpress.com/product/isbn/9781439879900

Physician Advisors: www.CertifiedMedicalPlanner.org

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By Staff Reporters

Some Topics of Interest for ME-P Readers

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US capitol

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Assessment

Enjoy these informative private sector and government publications.

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Hospitals: http://www.crcpress.com/product/isbn/9781439879900

Physician Advisors: www.CertifiedMedicalPlanner.org

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Why Hospitals Should Use Financial Management Checklists

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Financial Management Strategies for Hospital and Healthcare Organizations [Tools, Techniques, Checklists and Case Studies]

By Neil H. Baum MD

Dr. BaumIt is fitting that ME-P Editor Dr. David Edward Marcinko MBA CMP™ and his fellow experts, have laid out a plan of action in Financial Management Strategies for Hospital and Healthcare Organizations: Tools, Techniques, Checklists and Case Studies that physicians, nurse-executives, administrators and institutional Chief Executive Officers, Chief Financial Officers, MBAs, lawyers and healthcare accountants can follow to help move healthcare financial fitness forward during these unchartered waters.

In medicine – It all began with Dr. Atul Gawande, a surgeon at Massachusetts General Hospital, who reviewed the airline industry and their use of checklists prior to take off of an airplane.

The history of aviation checklists began in 1934 when Boeing was in the final process of testing a U.S. Army fighter plane with a potential contract of nearly 200 planes riding on the final test of the plane. The test aircraft made a normal taxi and takeoff. It began a smooth climb, but then suddenly stalled. The aircraft turned on one wing and fell, bursting into flames upon impact killing two of the test pilots. The investigation found pilot error as the cause. One of the pilots who was unfamiliar with the aircraft had neglected to release the elevator lock prior to take off. The contract with Boeing was in jeopardy.

Thus, the pilots sat down and put their heads together. What was needed was some way of making sure that everything to prevent crashes was being done; that nothing was overlooked. What resulted was a pilot’s checklist developed before takeoff, during flight, before landing, and after landing. These checklists for the pilot and co-pilot made sure that nothing was forgotten and safety of the planes was insured.

Medical Care and Hospitals

So, what does airline safety have to with medical care and hospitals?

There are so many activities that take place in medicine such as the operating room, that are far too complicated to be left to memory of doctors, nurses, anesthesiologists, and others involved in the surgical care of patients.  Dr. Gawande identified the key components of a surgical procedure which include the name of the patient, the procedure to be performed, the estimated length of the procedure, whether the right or left side is the surgical target, how much blood loss is anticipated, whether antibiotics have been given prior to making the incision, and the anesthetic risk of the patient.  This use of a checklist which takes approximately 30 seconds has not only prevented wrong side surgery but also instills a discipline of higher performance.

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Financial Management Strategies for Hospitals and Healthcare Organizations

Financial Management Strategies for Hospitals and Healthcare Organizations: Tools, Techniques, Checklists and Case Studies

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From the Clinic to the Boardroom

And so, should [can] we port the clinical checklist example of Atul Gawande for use with non-clinical topics like hospital financial management and administration?

Assessment

Yes – We have a challenge and the Financial Management Strategies for Hospital and Healthcare Organizations: Tools, Techniques, Checklists and Case Studies is a step in the direction to make all of the stakeholders in the healthcare arena become sensitive to reducing and controlling costs and at the same time preserve quality of care.

This can be done.  I suggest you start by reading, using and referring to this excellent book.

And so, what is my final advice? Read the Book!

Some of you who will read this book are CXOs COOs, Chief Medical Officers and maybe even COS. (Chiefs of Staff). But, all of you should become CLOs (Chief Life Officers)!  Read this book and the initials CLO will appear after your name!

Note:

Neil H. Baum MD is a Clinical Associate Professor of Urology at the Tulane Medical School, New Orleans, LA. He is also a thought-leader for this ME-P. 

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

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The Impact Of The U.S. Recession On Hospitals

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Drivers of Decline

Commercially insured scheduled admissions are the largest contributor to inpatient margins for the average US hospital. During the US recession (2009-2011), volumes in this segment declined. There were two primary drivers of this decline.

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Recession Impact

Dual Causes

First, commercial insurance coverage decreased, stemming from unemployment and underemployment. This is expected to reverse and rebound as the economy recovers and as healthcare reform is implemented.

Second, even among those who retained coverage, utilization of inpatient services decreased as patients delayed or forewent elective and preventative care. This was influenced by a range of economic factors, including reduced household incomes, higher co-pays, and a reduced ability to leave work for medical care, as well as factor unrelated to the recession, such as a shift to outpatient management of disease.

More: Are Cost Estimates Leading To The Wrong Decisions in US Hospitals?

Assessment

It is unclear whether this second driver will diminish fully as the economy recovers. A slow recovery – or one that fails to see volumes to return to pre-recession levels – suggests that hospitals may need to refocus their strategies on service lines and segments that have historically been less attractive.

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Hospitals: http://www.crcpress.com/product/isbn/9781439879900

Physician Advisors: www.CertifiedMedicalPlanner.org

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Case Model Illustration of a Six Sigma Healthcare Pioneer

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The Mount Carmel Health System

By Mark Matthews MD

A “Scrubbed” True Illustration

One of the earliest healthcare adopters of Six Sigma was the Mount Carmel Health System in Columbus, Ohio.

The organization was barely breaking even in the summer of 2000 when competition from surrounding providers made things worse. Employee layoffs added fuel to an already all-time low employee morale.

The CEO

Chief Executive Officer Joe Calvaruso was determined to stem the bleeding, break the cycle of poor financial performance and return the hospital system to profitability.  He sought the potential benefits of Six Sigma and began a full deployment of its methodology. The plan was a bold move, as the organization ensured that no one would be terminated as a result of a Six Sigma project having eliminated his or her previous duties. These employees would be offered an alternative position in a different department. Moreover, top personnel were asked to leave their current positions to be trained and work full time as Six Sigma expert practitioners who would oversee project deployment while their positions were backfilled.

Assessment

The Six Sigma deployment was the right decision. More than 50 projects were initiated with significant success. An example of an early Mount Carmel success story is the dramatic improvement in their Medicare + Choice product reimbursements, previously written off as uncollectible accounts. These accounts were often denied by HCFA due to coding of those patients as “working aged.”

Since the treatment process status often changed in these patients, HCFA often rejected claims or lessened reimbursement amounts, effectively making coding a difficult and elusive problem. The employment of the Six Sigma process fixed the problem, resulting in a real gain of $857,000 to the organization. The spillover of this methodology to other coding parameters also has dramatically boosted revenue collection.

A Glimpse of Lean Medical Management Tools and Techniques

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Hospitals: http://www.crcpress.com/product/isbn/9781439879900

Physician Advisors: www.CertifiedMedicalPlanner.org

From Our Newest Textbook Release

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BOOK FOREWORD / TESTIMONIAL

Succeed with the “Business of Medical Practice” Textbook

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[Transformational Health 2.0 Skills for Doctors]

By Ann Miller RN, MHA

www.BusinessofMedicalPractice.com

December 23rd, 2011 – The Institute of Medical Business Advisors [iMBA] Inc, in Atlanta, GA www.MedicalBusinessAdvisors.com and Springer Publishing Company of New York, just released the third edition of “The Business of Medical Practice” [Transformational Health 2.0 Skills for Doctors] edited by iMBA founder Dr. David Edward Marcinko MBA, CMP™ and President Hope Rachel Hetico RN, MHA, CPHQ, CMP™

Internal Contents

The 37 chapter, 750 page hard-cover textbook provides a comprehensive resource for those physicians, medical professionals, practice managers, nurse executives, health care administrators and graduate students seeking working knowledge on running a private facility or medical clinic.

Three Major Sections

The BoMP is comprised of three enterprise-wide sections: [1] Qualitative Office Operations, [2] Quantitative Aspects of Medical Practice and [3] Health Policies, Ethics and Leadership. Topics like ARRA, HITECH, ACA and the social networking aspects and ramifications of health 2.0 connectivity for all stakeholders are included for modernity.

Tools and Templates

Tools used throughout the book help readers reference and retain complex information. These tools include:

  • Sidebars. Key terms, key concepts, key sources, associations, and factoids all serve to enhance and reinforce the core takeaways from each chapter.
  • Tables. Tables are used to display and reference benchmark data, draw comparisons, and illustrate industry data trends.
  • Figures. Graphical depictions of concepts help you comprehend the material.
  • Charts. Charts allow easily referenced standard industry taxonomies alongside comparisons of related topics.

Assessment

For a further description of the Business of Medical Practice, with online “live’ community, please click: www.BusinessofMedicalPractice.com

To order directly: http://www.springerpub.com/product/9780826105752 

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

DICTIONARIES: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
BLOG: www.MedicalExecutivePost.com
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

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Vital iMBA Inc Links for Savvy Doctors and their Financial Advisors

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An Educational Resource Supporting Doctors and their Consulting Advisors 

Healthcare OrganizationsMedical Business AdvisorsCertified Medical PlannerHDS

We are an emerging online and onground community that connects medical professionals with financial advisors and management consultants. We participate in a variety of insightful educational seminars, teaching conferences and national workshops. We produce journals, textbooks and handbooks, white-papers, CDs and award-winning dictionaries. And, our didactic heritage includes innovative R&D, litigation support, opinions for engaged private clients and media sourcing in the sectors we passionately serve.

Through the balanced collaboration of this rich-media sharing and ranking forum, we have become a leading network at the intersection of healthcare administration, practice management, medical economics, business strategy and financial planning for doctors and their consulting advisors. Even if not seeking our products or services, we hope this knowledge silo is useful to you.

In the Health 2.0 era of political reform, our goal is to: “bridge the gap between practice mission and financial solidarity for all medical professionals.”

Join the ME-P Nation today … and tell us what you think!

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We are sponsored by the Institute of Medical Business Advisors, Inc

www.MedicalBusinessAdvisors.com

INSTITUTE OF MEDICAL BUSINESS ADVISORS, INC.
Suite #5901 Wilbanks Drive
Norcross, Georgia, 30092-1141 USA
Phone: 770.448.0769

ADMINISTRATORS: http://www.springerpub.com/Search/marcinko
PHYSICIANS:www.MedicalBusinessAdvisors.com
PRACTICE: www.BusinessofMedicalPractice.com
PODIATRISTS: www.PodiatryPrep.com
HOSPITALS:http://www.crcpress.com/product/isbn/9781439879900
ADVISORS:www.CertifiedMedicalPlanner.org
BLOG: www.MedicalExecutivePost.com

Assessment

Link: Letterhead.iMBA_Inc.

Link: Letterhead CMP

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

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Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Hospitals: http://www.crcpress.com/product/isbn/9781439879900

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Increasing Operating Room Efficiency and Flow-Thru Logistics

Achieving Better Prep, Execution, and Discharge in the OR

By Denice Soyring Higman

By Adam Higman

By Dragana Gough

http://www.soyringconsulting.com

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Pre-Operative Phase

The OR should run like a well-oiled machine with patients moving through each stage seamlessly as the slightest factor can have lasting negative effects.  As with most things, the process of improvement must start at the beginning with Pre-admission Preparation.  Ensuring that patient files have an up-to-date History and Physical (H&P) and Laboratory and Radiology reports, as well as financial clearance will aid in the improvement process.

Some Vital Queries

One of the keys to improving preoperative performance is involving physicians. Assess where things stand by asking these questions:

  • Is Anesthesia involved in team decision making?
  • Are Medical Staff taking an active role in throughput?
  • Is your Anesthesia staff reviewing patient charts for the next day?
  • Anesthesia staff should assess a scheduled patient when the health history suggests potential problems

Holding Area or Not?

It depends.  Most hospitals do not use holding areas for all patients, even though the areas may exist.  Typical uses for holding areas include inpatient surgery patients and anesthesia services for line insertions, etc.  For smoother transitions in the OR, you should consider elimination of multiple stops for outpatients.

Operative Phase

Operative throughput should start with an assessment of your instrument and supplies. This begins with a review of your case cart readiness, including the number of trays and instruments, used and unused.  The goal of this review is to eliminate any additional unneeded instrument counting/processing.  To avoid case delays, ensure that all materials and supplies pulled for the case are correct and your preference cards are updated.  As with any procedure, make sure that the equipment is functioning correctly and that all personnel are fully trained for the job.  Perform proper maintenance checks ahead of time and review storage and organization procedures to ensure that the equipment is readily available for the next case start time.  Unreliable items that frequently break/malfunction can have a huge effect on turnover.

Team Approach to Operating Room Turnover

It is imperative that the OR staff be ready to start on time and every person in surgery should have a part of the turnover process.  Surgeons can set the stage for expectations, especially if they are present during turnover/set-up.  Do not let them perform a disappearing act.  Work with surgeon’s office staff on scheduling issues if there continues to be a problem.  For Anesthesia, Scrub, and Circulator staff, create buy-in for quick turnover time, utilize specialty teams, if possible, publicize turnover results (monthly), and celebrate improvements.  Anesthesia can help transport patients from Holding/Day Surgery to OR and housekeeping needs to be readily available to assist with cleanup.  Nursing staff can assist with cleanup of rooms and patient transport.  The bottom line, everyone needs to pitch in whether it is in their “job description” or not.

Post-Operative Phase

To continue the momentum, make strides in post-op procedures starting with discharging from the post-anesthesia care unit (PACU).  Acute care facilities should consider discharging select, low acuity patients directly from PACU.

Pre-Order Now

We are now preparing the next edition of our book: “Healthcare Organizations” [Management Strategies, Tools, Techniques and Case Studies]. In-Process from: (c) Productivity Press 2012
http://www.crcpress.com/product/isbn/9781439879900

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Healthcare Organizations: www.HealthcareFinancials.com

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Financial Planning Handbook

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###

TESTIMONIAL

In his book Financial Planning Handbook for Physicians and Advisors, Dr. David E. Marcinko, MBA CMP® CFP® provides us with a simple and yet very complete view on the basics of financial planning that every physician should know in order to maximize our chances for success in the financial aspect of our medical careers and personal lives.

The book is well structured, organized and easy to read. Divided in ten chapters, it covers important aspects of personal financial planning such as insurance, home mortgages, retirement plans, auto buying, taxes and more. In an era where doctors must have a solid understanding of the basics of financial management, this book is a must-have on every physician’s private book collection.

Although not a substitute for a formal business education, this book will help physicians navigate effectively through the hurdles of day-to-day financial decisions with the help of an accountant, financial and legal advisors.  This book would make an excellent reference for teaching medical students and residents the basics of monetary management.

I highly recommend this book and commend Dr. Marcinko and the Institute of Medical Business Advisors, Inc. on a job well done.

Manuel J. Colón, MD

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Then, purchase our text books, white-papers, hand books, dictionaries and journal for deeper integrated industry specificity.

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Health Industry Collaboration and e-Patients

More on Inter and Intra Healthcare Stakeholder Relationships 

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According to Jennifer Tomasik MS [jtomasik@cfar.com], writing in the soon to be released ME-P textbook from iMBA Inc www.MedicalBusinessAdvisors.com: “Healthcare Organizations” [Management Strategies, Tools, Techniques and Case Studies], now in-process from (c) Productivity Press for 2012:

We are in a time of great change in healthcare. No one is certain how the future landscape will unfold, but it is clear that changes in regulation, reimbursement, technology, the economy, and science will significantly impact the work of those clinicians and administrators who dedicate their careers to improving patient care.

More Collaboration Needed

Experience has shown that better collaboration between patients and among the many different parts of the healthcare delivery system holds great potential to improve the quality of care and the relationships of those delivering it. It has also shown that the opportunities to improve collaboration are widespread.

Our focus, therefore, should be to introduce and share a selected set of tools that can be used to improve collaboration along several dimensions:

  • Clarifying roles and authority through decision charting,
  • Understanding the “give” and the “get” needed to establish effective alliances through the current state, and
  • Working jointly to establish and test a set of refined expectations through a physician-administrator compact.

Assessment

In the end, improved collaboration can help medical institutions with everything from inter professional productivity, to patient satisfaction to the most critical service of all: caring for patients and saving lives.

Link: http://www.crcpress.com/product/isbn/9781439879900

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Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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Buy from Amazon

Clarifying Some NPI Number Mis-Understandings

The NPI Number: What is is – How it works?

By Carol S. Miller RN, MBA

The National Provider Identifier (NPI) is a HIPAA Administrative Simplification Standard that provides a unique identification for covered health care providers, all health plans and health care clearinghouses.  The NPI must be used in administrative and financial transactions adopted under HIPAA and with one identifying number will simplify security and allow greater protection or encryption of the provider number.  The NPI can be used to identify the health care provider on prescriptions, COB between health care plans, inpatient medical record systems, program integrity files, and other areas.

Dependent on his/her medical practice, the provider can obtain an individual or group NPI; however, there are situations where an individual NPI number is required such as with the submission of pharmacy and lab claims.  The NPI remains with the provider regardless of job or location change.  NPI will eventually be the standard identifier for all e-prescribing under Medicare Part D.

A Ten Digit Number

The NPI is a ten digit, intelligence-free numeric identifier with a check digit in the last position to help detect keying errors.  If there is a security breach, the number in itself cannot identify the protected health organization.  The use of one identifier with a check digit simplifies encryption of this number when transmitted electronically and thereby enhances security.

On HIPPA

HIPAA also requires that employers have standard national numbers that identify them on standard transactions.  The Employer Identification Number (EIN), issued by the Internal Revenue Service (IRS) was selected as the identifier for employers.  This number is used as a Federal tax identification number for the means of identifying any business entity and for the purpose of reporting employment taxes.  The EIN number should be protected as a social security number is.

ITL and NIST

Both the Information Technology Laboratory (ITL) and the National Institute of Standards and Technology (NIST) are involved in the development of technical, physical, administrative, and management standards and guidelines for cost-effective security and privacy of sensitive unclassified information in federal computer systems.  These standards and guidelines can be applied to the management of medical IT.

Assessment

Additional reference material for NPI can be found at: www.cms.gov/nationalprovidentstand.

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Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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PRE-ORDER HERE

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On “Financial Planning for Physicians AND their Advisors”

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Management Strategies, Operational Techniques, Tools, Templates and Case Studies

Healthcare Organizations: Management Strategies, Operational Techniques, Tools, Templates and Case Studies

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Practice Management: http://www.springerpub.com/product/9780826105752

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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About Healthcare Financials.com

WELCOME ALL HEALTH 2.0 COLLEAGUES

[An Open Invitation]

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All hospitals and healthcare organizations, both emerging and mature, face a daunting financial scenario in today’s volatile healthcare reimbursement environment.  Decreasing revenues, increasing costs, and high consumer expectations present a complex challenge for CEOs, CFOs, physicians and nurse executives, administrators, financial advisors and department managers who must not only lead in today’s climate, but also position their organizations for tomorrow’s financial tumult and potential political changes of the Obama Administration.

Produced by a team of leading doctors, physician executives, nurses, medical professionals, economists, administrators, lawyers, and accountants, skilled business leaders and IT consultants, among many others; Healthcare Organizations [Journal of Financial Management Strategies] on CD-ROM, or SaaS, looks at ways to manage assets, costs, human resources and healthcare claims.  Everything – from inventory management to hybrid and activity based cost analysis in order to accelerate the cash conversion cycle – is scrutinized.  And, modern health economic themes like competitive strategy, workplace violence and financial benchmarks, for both public and private entities, are included.

We also examine contemporaneous topics such as the lessons learned from the corporate healthcare market competition and the PPMC imbroglio of the early 2000’s, and the domestic financial meltdown of 2009. This includes current methods for achieving hospital objectives, negotiating and analyzing cost-volume-profit contracts, and understanding the financial impact of regulatory requirements under HIPAA, STARK I-III, OSHA, the US Patriot Acts, the Deficit Reduction Act [DRA], the often contentious Sarbanes-Oxley Act, ARRA and HITECH Acts, and the Fair and Accurate Credit Transactions [FACT] Act.

In addition, information technology issues like electronic medical records (eMRs), RFID controls, RSS feeds and blogs, Health 2.0 initiatives and computerized physician order entry (CPOE) systems are examined in detail. Virtually no  operational, strategic business, health economics, or financial management topic is omitted.

“This wide-ranging examination of the fiscal

management scene for hospitals, healthcare

organizations, clinics and outpatient centers 

includes case models, extensive appendices, 

and detailed checklists and templates that

step the reader through a review of main

issues for each chapter.”

Health Care Organizations [Journal of Financial Management Strategies] on CD-ROM, or SaaS, is dedicated to meeting the administrative needs of our nation’s healthcare organizations in order to help them maintain a competitive edge in the markets they serve; and to take advantage of emerging business opportunities. We therefore invite you to be the first health economics cynosure in your hospital, facility, or healthcare system to join us for the journey.

Let Health Care Organizations [Journal of Financial Management Strategies] be your guide. 

Subscribe today … Succeed tomorrow!

Dr. David Edward Marcinko MBA, CMP

[Founder, CEO and Editor-in-Chief]

iMBA Inc – Suite #5901 Wilbanks Drive

Norcross, GA 30092-1141

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“Health Care Organizations” [Announcing our Newest Print Book for 2012]

Management Strategies, Operational Techniques, Tools, Templates and Case Studies [in-progress]

By Dr. David Edward Marcinko; MBA CMP

By Prof. Hope Rachel Hetico; RN MHA CMP

Price:  $69.95 est.
Cat. #:  K13750
ISBN:  9781439879900
ISBN 10:  1439879907
Publication Date:  April 15, 2012 est.
Number of Pages:  400 est.
Binding(s):  Hardback

TABLE OF CONTENTS [tentative] 

  1. Market Competition in Healthcare [Understanding the Current Strategic Eco-System]
  2. Medical Career Development [Transformation of Next-Generation Physician Executives and Leaders]
  3. Medical Process Strategic Improvement [Tracking Care with Outcomes Reporting] 
  4. Capital Formation Strategies for Hospitals [Institutional Types, Essentiality and Governance]
  5. Hospital Revenue Cycle Management [Strategic Monitoring and Augmentation] 
  6. Managing Health Information Technology [Exchanging Patient Data – The Benefits and Rewards]
  7. Strategies for Health Information Technology Security and Privacy [Understanding the Rules, Regulations, Penalties and Recovery Efforts]
  8. Lean Six Sigma Healthcare Operations [Improving Healthcare Quality]
  9. Strategic Financial Management Implications of the USA PATRIOT and Sarbanes-Oxley Acts [Health Policy for Affected Hospitals and Healthcare Organizations] 
  10. Collaboration to Improve Operating Performance [Opportunities are Widespread] 
  11. Healthcare Supply Chain Inventory Management [Data Capture, Just-in-Time Strategies and Economic Order Quantity Analysis]
  12. Improving Hospital Flow Through Efficiency, Operations and Logistics [Seeking Leaner and Faster Organizations with Sustainable Improvements]

Pre-Order Now

In-Process from: (c) Productivity Press 2012
http://www.crcpress.com/product/isbn/9781439879900

Conclusion

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Healthcare Organizations: www.HealthcareFinancials.com

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Guide to Biostatistics

Clinical Tools

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Here is a white paper of important epidemiological concepts and common bio-statistical terms to help doctors and related professionals translate medical research into everyday practice.

Link: http://www.medpagetoday.com/Medpage-Guide-to-Biostatistics.pdf

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Practice Management: http://www.springerpub.com/product/9780826105752

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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Understanding the Collaborative Shift in Bedside Manner

Doctor-Patient Relations in the Modern Era

By Mario Moussa PhD

By Jennifer Tomasik MS

www.BusinessofMedicalPractice.com

When it comes to the doctor-patient relationship, Health 2.0 needs guidelines. Several leading health providers have begun to call for them. We think guidelines would, among other things, help define the right mix of virtual and live communication.

Our relationship strategies take a step in this direction. Such a framework can be used to start a productive dialogue among health providers about social media. A hospital committee or some other governing body could easily use Web 2.0 tools—a blog or a wiki—to start the discussion. Before long, there would be ample case material to flesh out general principles.

Health 2.0 Needs Guidelines

Guidelines would also address a big barrier to using Health 2.0: getting paid. Currently reimbursement policies do not cover electronic communication, so physicians have little financial incentive to use it. In a 2003 study, only 9% of physicians were willing to use e-mail to communicate with patients. This has something to do with old habits. But it has a lot to do with payment schedules, too. Guidelines should feature the research that shows the positive health outcomes of strong physician-patient relationships and how social media tools help build relationships. In today’s “pay for performance” market, these outcomes help build credibility for wired communication.

Training Support

We also think Health 2.0 guidelines need to be supported by training. Studies show that training in interviewing and interpersonal skills produces substantial differences in the quality of care. Training in Health 2.0 communication would likely have a similar impact.

Assessment

Paradoxically, as patients can access and control more data, they have a greater need for trusted physicians who communicate well using various mediums. As Ted Epperly, President of the American Academy of Family Physicians, has said, patients need “wise counsel” in sifting through the prodigious amounts of information available via Health 2.0. And physicians as well as patients need to learn how to navigate this environment. No longer the sole authoritative source of medical information, physicians need to adapt, becoming an experienced partner and guide for inquiring patients. Training can help doctors get comfortable in this new role.

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com and http://www.springerpub.com/Search/marcinko

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko 

Practice Management: http://www.springerpub.com/product/9780826105752

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Subscribe Now: Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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Anderson, James G., Eysenbach, Gunther, and Rainey, Michelle R. “The Impact of CyberHealthcare on the Physician–Patient Relationship.” Journal of Medical Systems. 27 (2003): 67 – 84.

Kaplan, Sherrie H., Greenfield, Sheldon, Gandek, Barbara, et al. “Characteristics of physicians with participatory decision-making styles.” Annals of Internal Medicine. 124.5 (1996): 497–504

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Understanding the Physician-Entrepreneur’s Personality

13 Vital Questions for all Doctors to Consider

By Dr. David Edward Marcinko MBA, CMP™

[Editor-in-Chief]

www.BusinessofMedicalPractice.com

There is no way to eliminate all the risks associated with starting a medical practice, or launching any innovative concept in the health 2.0 ecosystem. However, entrepreneurial focused doctors can improve their chance of success with good planning and preparation. So, prior to starting your practice, merging, franchising or purchasing an existing one, ask yourself the following sobering questions. Hopefully, such reflection will enhance success, or at least prevent an unmitigated catastrophe. (www.sba.gov)

The Questions to Consider

1. Is medical practice ownership and physician entrepreneurship right for you?

It will be up to you, and your consultants; not someone else telling you to develop projects, organize your time or follow through on details. Your must be self motivated.

2. Do you like people and get along with different personality types?

Practice owners need to develop working relationships with a variety of people including patients, customers, vendors, staff, other physicians, and professionals like lawyers, accountants, consultants and bankers. Can you deal with a demanding patient, an unreliable vendor or cranky staff person in the best interest of your practice?

3. Can you make decisions and leave with ambiguity?

Practice owners are required to make independent decisions constantly; often quickly, under pressure and without all the facts. Ambiguity is a constant.

4. Do you have the physical and emotional stamina?

Practice ownership can be challenging, fun and exciting. But it’s also a lot of work. As a physician-owner, can you face twelve hour work days? As a doctor, can you offer advice, service, care and moral support 24/7?

5. How long can you live on your current savings?

Most small medical practice startups induce a declining bank balance in the early going. So, it’s wise to look at your expenses and determine how long you can live on your savings, and what personal costs you can temporarily eliminate. Emotionally, it’s easier to tighten expenses when you’re contemplating a new practice, than it is to cut back after you’ve started.  Financial consultants and accountants that perform consolidated financial statement preparation and analysis are vital in this regard. A two to five year margin of safety is not unusual and may be needed

6. How deeply in debt can you go?

Medical practice business debt can be good. It can fund expansion, improve profit ratios and cash flow. For physician entrepreneurs, business debt is often personal debt. Many start a practice by deferring payments for their own labor. Although lenders may make loans to a practice, the physician-owner will often be required to personally guarantee the loan. So, although the debt is on the business’s books, is ultimately the doctors’ debt should the practice fail.

7. What about health insurance?

If your current residency, fellowship or job offers health insurance, and is subject to the Consolidated Omnibus Budget Reconciliation Act (COBRA), you might be able to keep your coverage by paying the premiums, plus another 2% for administrative costs. You may keep your coverage under COBRA for up to 18 months and is a useful stopgap. For example, pay the premiums for six months or until another health insurance plan is obtained. Others suggestions are working spouse coverage with family benefits, or an HMO; or Medical or Health Savings Account (HSA/MSA).

8. Can you line up credit in advance?

Some new practice owners may set up a home equity line of credit that will let them borrow money at 1-2 percentage points over the prime rate or less. Lenders are more willing to make loans to someone who has a steady paycheck than to a new practice entrepreneur. If you have an excellent credit rating, you can probably get a home equity or other secured loan, but with more paperwork than in the recent past. Once you’re a self-employed practice owner, you’ll probably have to provide your most recent tax returns before getting approval. But, today, the biggest obstacle to a practice loan is a home mortgage. Domestic credit has been very tight since 2007, even for physicians.

9. What if you can’t manage the practice?

Disability insurance, unlike health insurance, usually cannot be transferred to an individual policy when you leave your job to start a new venture. So, get your own disability policy while you are still employed. Once you have the policy established and are paying the premiums, you should be able to keep the policy when you go out on your own. Remember, benefits received on a policy paid by you are free of federal income tax. Benefits on a policy paid for by a previous employer were taxable.

10. How well do you plan and organize?

Research indicates that many medical practice failures could have been avoided through better planning. Good organization of financials, inventory, schedules, information technology, medical services and human resources can help avoid many pitfalls.

11. Is your determination and drive strong enough to maintain your motivation?

Running a practice can wear you down. Some doctor-owners feel burned out by having to carry all the responsibility on their shoulders. Strong motivation can make the practice succeed and will help you survive slowdowns as well as periods of burnout.

12. How will the practice affect your family?

The first few years of practice startup can be hard on family life. The strain of an unsupportive spouse may be hard to balance against the demands of starting a medical business. There also may be financial difficulties until the business becomes profitable, which could take years. You may have to adjust to a lower standard of living or put family assets at risk.

13. How do you feel about the Patient Protection and Affordable Care Act of 2010?

Most provisions of the PPACA take effect over the next four to eight years, including expanding Medicaid eligibility, subsidizing insurance premiums, providing incentives for businesses to provide health care benefits, prohibiting denial of coverage/claims based on pre-existing conditions, establishing health insurance exchanges, and support for medical research. The expense of these provisions are offset by a variety of taxes, fees, and cost-saving measures, such as new Medicare taxes for high-income brackets, cuts to the Medicare Advantage program in favor of traditional Medicare, and fees on medical devices and pharmaceutical companies. There is also a tax penalty for citizens who do not obtain health insurance. Decreased physician reimbursement is a component, as well.

Assessment

More info: www.BusinessofMedicalPractice.com

I am available for queries – thanks again for your interest.

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. Are you a medical innovator or healthcare entrepreneur? Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

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Hospitals and Healthcare Organizations [Print Book]

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A National Team of Contributors

Produced by a national team of professionals, economists, administrators, lawyers, and accountants, skilled business leaders and IT consultants, among many others; Healthcare Organizations [Journal of Financial Management Strategies] on CD-ROM, or SaaS, looks at ways to manage assets, costs, human resources and healthcare claims.  Everything – from inventory management to hybrid and activity based cost analysis in order to accelerate the cash conversion cycle – is scrutinized.  And, modern health economic themes like competitive strategy, workplace violence and financial benchmarks, for both public and private entities, are included.

Contemporaneous Health 2.0 Topics

We also examine contemporaneous topics such as the lessons learned from the corporate healthcare market competition and the PPMC imbroglio of the early 2000’s, and the domestic financial meltdown of 2009. This includes current methods for achieving hospital objectives, negotiating and analyzing cost-volume-profit contracts, and understanding the financial impact of regulatory requirements under HIPAA, STARK I-III, OSHA, the US Patriot Acts, the Deficit Reduction Act [DRA], the often contentious Sarbanes-Oxley Act, ARRA and HITECH Acts, and the Fair and Accurate Credit Transactions [FACT] Act. In addition, information technology issues like electronic medical records (eMRs), RFID controls, RSS feeds and blogs, Health 2.0 initiatives and computerized physician order entry (CPOE) systems are examined in detail. Virtually no operational, strategic business, health economics, or financial management topic is omitted.

Assessment

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About Our Newest Practice Management Book

MEDICAL PRACTICE MANAGEMENT EDUCATION:
The Business of Medical Practice [Transformational Health 2.0 Skills for Doctors]

www.BusinessofMedicalPractice.com

Front Matter BoMP – 3

David E. Marcinko; Hope Rachel Hetico
December 2010 – 750 pp Hardcover (C) 2011
ISBN: 9780826105752  – Price: $95.00 

Reach the Executive Decision-Makers!

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An Emerging Values-Based Healthcare Payment Model

Understanding Non-Traditional Physician Reimbursement Paradigms

By Staff Reporters

www.BusinessofMedicalPractice.com

According to Brian Knabe MD, Mark Fendrick, MD and Michael E. Chernew, PhD, instead of the one size fits all approach of traditional health insurance reimbursement, a “clinically-sensitive” cost-sharing system that supports co-payments related to evidence-based value for targeted patients seems plausible.

The New Model

In this model, out-of-pocket costs are based on price and a cost/quality tradeoff in clinical circumstances: low co-payments for interventions of highest value, and higher co-payments for interventions with little proven health benefit. Smarter benefit packages are designed to combine disease management with cost sharing to address spending growth.

Assessment

Today, whether independent or employed, physicians can pursue creative compensation models not like the one briefly described above and unknown just a decade ago.

Conclusion

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Useful Managed Care Provider, Staffing, Activity and Financial Trends

Part Two

By Dr. David Edward Marcinko MBA

[Publisher-in-Chief]

Dr. DEMIf you read this ME-P regularly or have read my earlier blogs, you know that I am writing a book on practice management for the private medical practitioner.

The Business of Medical Practice [Transformational Health 2.0 Skills for Doctors]; third edition: www.BusinessofMedicalPractice.com

Link: Front Matter BoMP – 3

A recent story in the Chicago Tribune on the difficult business life of private practitioners today reminds me that I need to keep my nose to the grindstone.

For example, according to the sanofi-aventis Pharmaceutical Company Managed Care Digest Series, for 2008-10, the following patterns and comparative trend information has been empirically determined and may provide a basic starting point for medical practitioners to share business management, facilities, personnel, and records information for enhanced success www.managedcaredigest.com

Mid-Level Provider and Staffing Trends

  • Mid-level provider use increased among multi-specialty groups, especially in those with more than half of their revenue from capitated contracts. Use also rose with the size of the practice and was highest with OB/GYN groups.
  • Medical support staff for all multi-specialty groups fell and was lowest in medical groups with less than 10 full-time equivalent (FTE) physicians. However, groups with a large amount of capitated revenue actually added support staff. Smaller groups limited support staff.
  • Compensation costs of support staff increased and the percentages of total operating costs associated with laboratories, professional liability insurance, IT services, and imaging also increased. Support staff costs increase with capitation levels and more than half of all operating costs are tied to support staff endeavors.

Managed Care Activity and Contracting Trends

  • More medical group practices are likely to own interests in preferred provider organizations (PPOs) than in HMOs and the percentages of groups with managed care revenue continues to rise. Multi-specialty and large groups also derive more revenue from MCOs than single specialty or smaller groups.
  • Managed care has little effect on physician payment methods that are still predominantly based on productivity. Physicians were paid differently for at-risk managed care contracts in only a small percentage of cases.
  • Most medical groups (75%) participating in managed care medicine have PPO contracts. Group practices contract with network HMOs more often than solo practices. Single-specialty groups more often have PPO contracts.
  • Capitated lives often raise capitation revenues in large group practices. Group practices are more highly capitated than smaller groups or solo practices. Almost 30% of highly capitated medical groups have more than 15 contracts and 22% have globally capitated contracts.
  • Higher capitation is linked with increased risk contracting. Larger groups have more risk contracting than smaller groups.

Physician Health

Financial Profile Trends

  • Medicare fee-for-service reimbursement is decreasing. Highly capitated groups incur high consulting fees.
  • The share of total gross charges for OB/GYN groups associated with managed care at-risk contracts is rising while non-managed care, or not-at-risk charges are declining.
  • Capitated contracts have little effect on the amount of on-site office non-surgical work. Off-site surgeries are most common for surgery groups, not medical groups.
  • Half of all charges are for on-site non-surgical procedures.
  • Highly capitated medical groups have higher operating costs and lower net profits.
  • Groups without capitation have higher laboratory expenses than those who do.
  • Physician costs are highest in orthopedic surgery group practices. Generally, median costs at most specialty levels are rising and profits shrinking.

Assessment

Obviously, the above information is only a gauge since regional differences, and certain medical sub-specialty practices and carve-outs, do exist.

Part One: Useful Managed Care Patterns and Procedural Utilization Trends

Conclusion

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Events Planner: November 2010

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Events-Planner: NOVEMBER 2010

By Staff Writers

“Keeping track of important health economics and financial industry meetings, conferences and summits”

Welcome to this issue of the Medical Executive-Post and our Events-Planner. It contains the latest information on conferences, news, and relevant resources in healthcare finance, economics, research and development, business management, pharmaceutical pricing, and physician/entity reimbursement!  Watch for a new Events-Planner each month.

First, a little about us! The Medical Executive-Post is still a relative newcomer. But today, we have almost 175,000 visitors and readers each month from all over the country, in addition to our growing subscriber base. We have been a successful collaborative effort, thanks to your contributions.  As a result, we are adding new resources daily. And, we hope the website continues to provide the best place to go for journals, books, conferences, educational resources, tools, and other things you need to establish the value your healthcare consulting and financial advisory intervention.

So, enjoy the Medical Executive-Post and this monthly Events-Planner with our compliments. 

A Look Ahead this Month: Now, the important dates:

November 07: World Congress Health Innovation Meeting. Alexandra, VA

November 08: Patient Centered Medical Homes and ACOs, Hartford, CT

November 08: Medical Compliance Meeting in a Post Reform World, Baltimore, MD

November 11: Conducting Effective internal Medical Investigations, HCCA, Orlando, FL

Please send in your meetings and dates for listing in the next issue of our Events-Planner.

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Insurance and Risk Management Strategies for Physicians and Advisors

A Handbook for Doctors

By ME-P Staff Reporters and their Consulting Advisors

For practicing physicians, selecting a knowledgeable insurance advisor and developing a comprehensive personal and corporate risk management plan can be a daunting task. As a consequence of today’s litigious environment in the healthcare industry, physicians must now carefully assess their personal and practice risks as they seek to be indemnified should an event or cause of action occur. This process requires integrated knowledge of the healthcare industrial complex, as well as the rapidly changing insurance industry.

The Reality

Fortunately, Insurance and Risk Management Strategies for Physicians and Advisors confronts the reality that insurance planning in healthcare is decidedly more complex than most other businesses or professions and, in an easy-to-understand manner, explains to physicians and insurance professionals the background, theory, and practicalities of medical risk management and insurance planning.

Certified Medical Planner® Dr. David Edward Marcinko and his team of contributing authors go into great depth on the growing range of insurance planning options in order to assist physicians, and their advisors, to choose the “right” course that balances risk, cost, time, outcome as well as his or her own personal risk tolerance life style.

Insurance and Risk Management Strategies for Physicians and Advisors is ideal for medical professionals and the insurance advisors who seek to serve them, as well as for financial planners, insurance agents and healthcare business advisors wishing to re-educate and help doctors by adding lasting value to their client relationships.

Assessment

Includes tools, templates, case studies, glossary of terms, and examples required to make insurance issues “come alive” in a real world setting

From the Foreword:

“Insurance and Risk Management Strategies for Physicians and Advisors is an essential textbook because it explains to physicians and insurance professionals the background, theory, and practicalities of medical risk management and insurance planning.  The insurance haze is lifted by dual-degreed editor, and Certified Medical Planner© Dr. David Edward Marcinko, and his team of contributing authors.

Insurance and Risk Management Strategies for Physicians and Advisors fulfills its promise as a peerless tool for physicians wanting to make good decisions about the risks they face. It is also ideal for financial planners, insurance agents and healthcare business advisors wishing to re-educate and help doctors by adding lasting value to their client relationships. With time at a premium for all, and so much information packed into one well-organized resource, this book should be on the desk of every physician, or financial advisor serving the healthcare space.

Simply stated, if you read this compelling text with a mind focused on the future, the time you spend will be amply rewarded.”

Lloyd M. Krieger, MD, MBA
Rodeo Drive Plastic Surgery
The Rodeo Collection
421 North Rodeo Drive
Beverly Hills, CA 90210
Phone: 310.550.6300
Fax: 310.550.6363
Email: lkrieger@ucla.edu
http://www.RodeoDrivePlasticSurgery.com

Link: http://www.jblearning.com/catalog/9780763733421/

Conclusion

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Book Review and Order Placement

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“Live” Website Community

www.BusinessofMedicalPractice.com

About the Editor-in-Chief

Dr. David Edward Marcinko, a former residency director, department chairman, and hospital vice-president in Atlanta GA, retired from clinical practice at the age of 45 after selling his Ambulatory Surgery Center to a public company. As a fellow and board certified surgeon, he authored more than two dozen medical and business textbooks in three languages, teaching and operating in the EuroZone, co-founding a pre-IPO PPMC, and forming a series of successful internet ventures while still maintaining a 60 hour work week.  

His companies have created dozens of cognitive products in the last few years that maintain a comfortable lifestyle that started from his home office after retirement. Dr. Marcinko picked up an MBA degree, became a certified financial planner and insurance agent, and developed a cult following thru collaborative on-ground and online education for physicians, financial advisors and management consultants. A social media pioneer and publisher, this Medical Executive-Post is an influential syndicated blog with thousands of content contributions from nationally know experts. 

Dr. Marcinko is a highly sought after futurist and speaker in the areas of health economics, financial planning, medical practice management and related entrepreneurial e-insights for intersecting sectors in the healthcare industrial complex.

Edited with Professor Hope Rachel Hetico of the Institute of Medical Business Advisors [iMBA] Inc www.MedicalBusinessAdvisors.com

Financial Planning and Risk Management Handbooks for Doctors 

On Evidence-Based Clinical Medical Guidelines

About the Institute for Clinical Systems Integration [ICSI] 

By Brent A. Metfessel MD, CMP™

www.BusinessofMedicalPractice.com

The Institute for Clinical Systems Integration (ICSI) is a strong proponent of the value of evidence-based clinical guidelines, and cites the following objections that make their implementation and acceptance more difficult.

 

The Issues

These issues generally apply to technology assessments as well:

  • Guidelines are a legal hazard:  There is a fear that following a guideline that turns out to be wrong increases the risk of litigation.  Good guidelines, however, are evidence-based and not opinion-based drivers of care.  Furthermore, once a review of the literature takes place and is synthesized into a preliminary guideline, multi-specialty physician focus groups review the guidelines prior to finalization.  The strength of evidence supporting each conclusion is usually stated, highlighting areas of remaining scientific uncertainty.  “Evidence hierarchies” are often used as aids to grading recommendations, with meta-analysis, systematic reviews, and randomized controlled trials being at or near the top of the hierarchy in strength, with narrative reviews, case reports, and medical opinion pieces being considered the weakest forms of evidence.  This provides additional checks and balances to guideline development.
  • Guidelines are cookbook medicine:  Guidelines are just that – guidelines.  Each patient should be provided treatment according to his/her individual needs.  Evidence-based clinical guidelines are based on extensive reviews of the literature and are applicable to the vast majority of cases for a particular clinical condition but not necessarily all cases.  In the case of practice pattern evaluation or profiling, comparisons of such patterns to medical guidelines can help identify overall systematic variations from the norm rather than variations due to particular patients with special needs.
  • Guidelines do not work:  When used as the sole basis for practice improvement, this statement contains some truth. However, when incorporated into a systematic continuous quality improvement approach, they have been shown to improve practice patterns and reduce variation.
  • Physicians will not use guidelines:  Once physicians know that the guidelines are based on a sound review of the medical literature, practitioner buy-in greatly increases.  In addition, clinicians need to realize that clinical guidelines are only one part of the total treatment picture since a team approach to patient care is becoming the norm.
  • Guidelines need validation through actual outcomes data:  This is correct when based on a continuous quality improvement approach, but is incorrect if outcomes are based on individual events.  Local implementation of guidelines can be compared to outcomes data one or two years after implementation.  Depending on the actual level of practice pattern improvement, minor alterations can be made to the guidelines to reflect local needs.

Guideline Adaptation

National guidelines in some cases may need adaptation to local patient needs and concerns.  For example, a practice in a major metropolitan area where specialty care is readily available differs in major ways from a rural practice which is based more on primary care.  Practices where many patients are poor or on public assistance also differs from practices in affluent areas.  When used as basic guides to appropriate practice, however, clinical guidelines can significantly decrease practice variation.

Evidence Based Medicine

With the recent emphasis on evidence-based medicine and on decreasing the time lag between evidence publication and its effect on actual patient care, a number of agencies have added clinical guideline and technology assessment development to their task lists.  Such agencies include specialty societies such as the American College of Cardiology (ACC), private companies and non-profit organizations, governmental bodies such as the Agency for Health Care Research and Quality (AHRQ), and MCOs that review the scientific evidence for the purpose of determining coverage policy.

Assessment

MCOs may post medical coverage policies on the Web for physicians to access, and these generally contain narrative justifications (often with evidence grading) in terms of why a particular procedure or diagnostic test may or may not be covered based on level of efficacy shown in scientific studies.  It is important to note that for many high-tech or new procedures, different MCOs may have somewhat different coverage policies based on variation in terms of interpreting the evidence, especially in areas where the science is less certain.

Conclusion

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Essay on Healthcare Leadership

Versus Healthcare Management

By Eugene Schmuckler PhD, MBA and Dr. David Edward Marcinko MBA

www.BusinessofMedicalPractice.com

Many times, individuals or physicians will use the terms management and leadership synonymously. In actuality the terms have significantly different meanings.

For example, Warren Bennis describes the difference between managers and leaders as “Managers do thing right, Leaders the right thing.”

The Managers

Managers are those individuals who have as their primary function managing a team of people and their activities. In effect, managers are those who have been given their authority by the nature of their role and ensure that the work gets done by focusing on day to day tasks and their activities.

On other hand, a leader’s approach is generally innate in its approach. Good leadership skills are difficult to learn because they are far more behavioral in nature than those skills needed for management. Leaders are also very focused on change recognizing that continual improvement can be achieved in their people and their activities can be a great step towards continued success.

Leadership Development

Perhaps some of the best training grounds for the development of leaders are the military. The Marine Corps slogan is “A Few Good Men” and the military academies at Annapolis (Navy), New London, Connecticut (Coast Guard), Colorado Springs (Air Force), and West Point (Army) all have as their main mission, the development of leaders. This is done by a number of different techniques. At graduation, the new officers, regardless of the branch of service, have been taught, and more importantly, have internalized the following: communicate the missions, sensitivity matters, real respect is earned, trust and challenge your soldiers. It is due to these lessons that many graduates of the military academies go on to positions of leadership in the private sector as well as in government.  Communicating the mission refers to conveying to those who work with us what are practice is hoping to accomplish and the role of each employee in achieving that goal. Given an understanding and awareness of the mission, when confronted with a barrier, employees are able to face hard problems when there is no well-defined approach by which to deal with them.

Sensitivity does matter - A leader treats each employee with respect and dignity, regardless of race, gender, cultural background or particular role they actually perform in the practice. Consider how many legal suits are filed against any type of organization, whether it is a medical practice or a large manufacturing facility due to perceived disparate treatment towards the employee based on race, religion, gender sexual preference or other non-work related issues.

Real respect is earned – Having initials after one’s name and the wearing of a lab coat does not automatically entitle an individual to respect. Formal authority has been found to be one of the least effective forms of influence. Only by earning the respect of your staff as well as your patients can you be sure that your intent will be carried out when you are not present. Setting the example in performance and conduct, rather than ‘do as I say, not as I do,” level of activity enables one to exert influence far greater than titles.

Trust and challenge your employees - How many times have practices sought to hire the best and brightest only to second guess the employee. Eric Schmidt, the CEO of Google, describes his management philosophy as having “… an employee base in which everybody is doing exactly what they want every day.” Obviously there are certain policies and procedures, but at the same time, the leader enables decision making to the lowest possible level. This also enables employees to question why certain policies and procedures are still being followed when more effective and efficient methods are available.  (How the Army Prepared Me to Work at Google, Doug Raymond, Harvard Business)

Internal Faults

The phrase “Physician, heal thyself” (Luke 4:23, King James Version) means that we have to attend to our own faults, in preference to pointing out the faults of others. The phrase alludes to the readiness of physicians to heal sickness in others while sometimes not being able or will to heal themselves.  By the same token, it now is necessary for us to learn how to manage ourselves. It suggests that physicians, while often being able to help the sick, cannot always do so, and when sick themselves are no better placed than anyone else (Gary Martin, phrases.org.uk/meanings/281850.html, 2010).

Self Development

“We will have to learn how to develop ourselves. We will have to place ourselves outside the boundaries where we can make the greatest contribution. And we will have to stay mentally alert and engaged during a 50-year working life, which means knowing how and when to change the work we do” (Managing Oneself, Harvard Business Review – Jan. 2005 – pp 100-109, by Peter Drucker).  Although one’s IQ and certain personality characteristics are more or less innate and appear to remain stable over time there are individual capabilities that enable leadership and can be developed. Enhancement of these capabilities can lead to the individual being able to carry out the leadership tasks of setting direction, gaining commitment, and creating alignment. These capabilities include self-management capabilities, social capabilities and work facilitation capabilities.

Assessment

Without question, while it is possible to cram for at test and graduate at the top of one’s class, that does not assure   leadership ability. We all know at least one person who scores at the highest levels on cognitive measures but would be incapable of pouring liquid out of a boot if the instructions were written on the heel.

Conclusion

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Dealing With Uncertainty in Practice Measurement

Understanding Variations in Medical Care Quality

By Brent A. Metfessel MD, CMP™

www.BusinessofMedicalPractice.com

Due to high-profile concerns in terms of the variation in quality of care as well as its affordability, practice pattern measurement is here to stay.  And, until further advances in this area are created, physicians with unexpectedly poor performance ratios, especially in the area of cost-efficiency, should review their data to determine if there are opportunities to improve as well as potential outlier cases contributing to an aberrant value, as well as looking at the health plan methodology for statistical analysis and outlier exclusions. 

Communication is Key

It is important for the physician or other provider being measured to communicate any issues to health plan personnel where possible. Physicians need to remember that practice pattern analysis is a continually evolving field. 

Assessment

Given the state of the art, physicians, specialty societies, and other advocacy groups have a responsibility to work with health plans or other practice measurement agencies to make sure quality improvement is at the forefront, that they are active in giving feedback on health plan practice measurement methods, and that as much as possible a collaborative approach is used in working with health plans and other measurement organizations.

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Understanding Disease Management

Certified Medical Planner

How Technology Affects Patient Care

By Brent A. Metfessel MD, CMP™

www.BusinessofMedicalPractice.com

One area where technology assessments, clinical guidelines, and EMR data can make a true difference in patient care is in disease management.

DMAA Definition

The Disease Management Association of America (DMAA) defines disease management as “a system of coordinated health care interventions and communications for populations with conditions in which patient self-care efforts are significant”.  Disease management supports the physician-patient relationship and places particular significance on the prevention of exacerbations and complications of chronic diseases using evidence-based clinical guidelines and integrating those recommendations into initiatives to empower patients to be active partners with their physicians in managing their conditions.

Usual Conditions

Typically, targets for disease management efforts include chronic conditions such as asthma, diabetes, chronic obstructive pulmonary disease, coronary artery disease, and heart failure, where patients can be active in self-care and where appropriate lifestyle changes can have a significant favorable impact on illness progression.

Outcomes Measurement

The DMAA also emphasizes the importance of process and outcomes measurement and evaluation, along with using the data to influence management of the medical condition.

Assessment

Although claims and administrative data can be used to measure and evaluate selected processes and outcomes, EMRs will be needed to capture the full spectrum of data for analyzing illness response to disease management programs and to support necessary changes in care plans to improve both intermediate outcomes (such as lab values), and long-range goals (such as the prevention of illness exacerbations, managing co-morbidities, and halting the progression of complications).

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Financial Planning for Physicians and Advisors

Our Handbook

By Ann Miller RN, MHA

Managed care and government-led initiatives to control health care costs have decreased physician compensation. Physicians must now carefully plan their practices and seek financial security in a manner that is markedly different from other professionals. To do so, physicians and their advisors must be well informed about the growing range of financial planning options to choose the course that balances risk, cost, time horizon, outcome and their own personal economic style. This innovative guide confronts the reality that personal financial planning for physicians is decidedly more complex than it is in other professions.

Financial Planning for Physicians and Advisors

This handbook describes a personal financial planning program to help doctors avoid the perils of harsh economic sacrifice. It outlines how to select a knowledgeable financial advisor and develop a comprehensive personal financial plan, and includes important sections on: insurance and risk management, asset diversification and modern portfolio construction, income tax and retirement planning, and succession and estate planning. When fully implemented with a professional’s assistance, this book will help physicians and their financial advisors develop an effective long-term financial plan.

Assessment

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Conclusion

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How eMR Vendors May Mislead You

Challenging Assertions

By Shahid N. Shah MS

As the physician executive of your medical practice, it’s your job to challenge any eMR vendors’ assertions about why you need an eMR, especially during the selection and production demonstration phase.

Information Availability [Anytime – Anywhere]

The most important reason for the digitization of medical records is to make patient information available when the physician needs that information to either care for the patient or supply information to another caregiver.

Electronic medical records are not about the technology but about whether or not information is more readily available at the point of need.

Reasons to Purchase?

In no particular order, the major reasons given for the business case of eMRs by vendors include:

• Increase in staff productivity
• Increase of practice revenue and profit
• Reduce costs outright or control cost increases
• Improve clinical decision making
• Enhance documentation
• Improve patient care
• Reduce medical errors

Assessment

So, doctors beware! Challenge vendor “authority.”

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Editor’s Note

Shahid N. Shah is an ME-P thought leader who is writing Chapter 13: “Interoperable e-MRs for the Small-Medium Sized Medical Practice” [On Being the CIO of your Own Office] for the third edition of the best selling book: Business of Medical Practice [Transformational Health 2.0 Skills for Doctors] to be released this fall by Springer Publishers, NY. He is also the CEO of Netspective Communications, LLC.

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Conclusion

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What is M-Health for Physicians?

On “Smart Phones” and Mobiles Devices

By Shahid N. Shah MS

M-Health or “mobile health” is an industry term for collectively defining those tools and technologies that can be used on “smart phones” like iPhone, Blackberry, Android, or on traditional mobile phones from various vendors.

Unlike traditional computers, almost every patient that walks into your medical office, as well as all your own staff, have mobile devices already. If you can find mobile applications that can help your practice you can immediately put to use without large capital expenses, network configuration, and other technical tasks.

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The M-Health Initiative

According to the mHealth Initiative, there are 12 major “application clusters” in mobile health: patient communication, access to web-based resources, point of care documentation, disease management, education programs, professional communication, administrative applications, financial applications, emergency care, public health, clinical trials, and body area networks.

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The Applications

Almost all of these applications are focused around the patient but most of them will be directly useful to you and your staff as well. Here’s how:

  • Improving physician-patient communications. You can get your staff to send out text messages, e-mails, photos, and other information about your practice to the patient before their visit. You can remind them about appointments, tell them what to expect, ask them for their insurance and check-in information, or let them send you their personal health record link. During the visit you can send them patient education information directly to their phones instead of handing out paper. After the visit you can send medication reminders, additional educational resources, and update to their personal health record, or ask them to join a Health 2.0 social network. PumpOne, GenerationOne, Intouch Clinical, Life:Wire, and Jitterbug phones all have great patient user experiences and you should tell your patients about them.
  • Faster access to information for you and your patients. There are countless web-based resources that are now at your fingertips on a phone. Patients can lookup providers, labs, testing services, etc. that you can refer them to; you can help them join clinical trials, and manage their health records online. None of these require a computer either in your office or in their home, it can all be done on the phone. Check out companies like Healthagen and iSeek.
  • Real-time documentation of office or hospital visits. Most of the things you want to do in your EMR are possible on a smart phone today. You can get your patient profiles, document an encounter with basic order management and lab results review capabilities, and immediate storage into either your own EMR or your hospital’s information system.
  • Help those patients with the most time-consuming treatments. You already know that disease management is an important part of managing the health of chronic patients; diabetes and hypertension are two perfect examples. Help enroll your patients into Diabetes Connect, MediNet, HealthCentral, and similar applications that can help track compliance with your medical treatment guidance. If they use these applications they can simply give you printouts or login credentials so that you can track their progress without doing any data entry yourself. There are patient tools for most common diseases.

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Editor’s Note

Shahid N. Shah is an ME-P thought leader who is writing Chapter 13: “Interoperable e-MRs for the Small-Medium Sized Medical Practice” [On Being the CIO of your Own Office] for the third edition of the best selling book: Business of Medical Practice [Transformational Health 2.0 Skills for Doctors] to be released this fall by Springer Publishing, NY. He is also the CEO of Netspective Communications, LLC.

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Conclusion

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Documentation for a Medical Practice FMV Appraisal

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Office Operations and Processes also Important

By Dr. David Edward Marcinko; MBA, CMP™

[Editor-in-Chief]

To successfully complete a medical practice financial analysis and fair-market valuation [FMV] engagement, the following is a description of the documents that are typically required.

According to Robert James Cimasi MHA, AVA, CMP™ of Health Capital Consultants LLC, most of this information is analogous to that required for the valuation of other types of healthcare service sector entities.

A. Important Documents

  • Historical Financial Statements

Important for identifying key variables and trends for analysis. The consultant should obtain year-end financial statements for a sufficient, relevant period to allow reliable analysis, e.g., the most recent three-five years. If, however, significant changes such as technological upgrades, product shifts, or environmental changes have occurred or the five-year period is not long enough, or too short, to assess the entity’s performance during changes in its business cycle or economic conditions, a longer or shorter period may be needed.

  • Tax Returns

Obtain tax returns to understand the entity’s tax position and to obtain additional accurate financial data. The returns provide a summary of tax policies and elections that affect tax expense and net income.

  • Forecasts and Proformas

Prospective financial information (e.g., forecasts, proformas, and budgets) should be requested to provide an indication of the entity’s opinion of its earnings potential as well as its historical ability to meet projections. This data may be especially useful if the consultant must produce a proforma or valuation of future earnings or cash flows.

  • Legal Documents

The consultant should review all significant legal documents to obtain an understanding of the ownership interests and relationships and to determine if contractual arrangements affect the entity’s operations and overall value. Some of the documents to be reviewed include:

Articles of Incorporation, stockholder, or partnership agreements. These agreements indicate ownership interests and the owners’ rights and obligations. Also, any stock option agreements should be considered. This will help the consultant determine or verify the type of interests involved.

Stock books. Review of these can help the consultant ascertain the relative size of various ownership interests and identify transactions in the entity’s stock.

Existing buy-sell agreements. These may provide an indication of the value of the entity or an ownership interest in it. Such agreements, however, are often structured based on factors other than the entity’s fair market value.

Purchase and sale agreements involving prior transactions of the entity’s stock. These provide indications of the entity’s value and any offers or letters of intent to sell or purchase stock should be carefully reviewed under IRS Revenue Ruling 59-60, which includes “Sales of the stock and the size of the block of stock to be valued” in a list of factors that, “although not all-inclusive are fundamental and require careful analysis in each case.” IRS Ruling 59-60 further requires:

   Sales of stock of a closely held corporation should be carefully investigated to determine whether they represent transactions at arm’s length. Forced or distress sales do not ordinarily reflect fair market value nor do isolated sales in small amounts necessarily control as the measure of value. This is especially true in the valuation of a controlling interest in a corporation. Since, in the case of closely-held stocks, no prevailing market prices are available, there is no basis for making an adjustment for blockage. It follows, therefore, that such stocks should be valued upon a consideration of all the evidence affecting the fair market value. The size of the block of stock itself is a relevant factor to be considered. Although it is true that a minority interest in an unlisted corporation’s stock is more difficult to sell than a similar block of listed stock, it is equally true that control of a corporation, either actual or in effect, representing as it does an added element of value, may justify a higher value for a specific block of stock.

Managed care and other service contracts. Types and numbers of managed care contracts should be reviewed, including whether they are with healthcare maintenance organizations (HMOs), preferred provider organizations (PPOs), or point-of-service (POS) contracts; whether they are on a discounted fee-for-service basis and if so, the size of the discount; whether they include a withhold percentage to only be paid based on quality criteria; or whether they are a flat fee per enrollee (“capitated”). Special terms such as the non-transferability of the contract to a new owner must be noted, e.g., managed care contracts often require that the provider be included on a panel of credentialed providers in order to contract to provide services.

Key doctor and managers’ employment contracts. Such agreements can reveal excess compensation above fair market value or “golden parachute” provisions in the event the business is sold.

Loan and lease agreements. These agreements may contain restrictive covenants, special demand clauses, or working capital requirements that affect the value of the entity. The length and terms of lease agreements is also important.

Documents relating to current, pending, or threatened litigation. These may indicate major contingent liabilities that may affect an entity’s value.

Patent/trademark documents. These documents may indicate the existence of valuable intangible assets. The absence of these documents could indicate the absence of a value consideration claimed by the client.

appraisers

  • Office operations and Staff

Consultants should also gain an understanding of the entity’s operations and key personnel. This can be accomplished by touring the facilities, interviewing key managers, and obtaining additional operational data. Obtaining enough information to thoroughly understand the entity, its operations, and its environment is the objective. The consultant becomes aware of operational data or contracts that may affect value by reviewing the following types of documents:

Corporate documents, including stockholder and director lists, compensation schedules for officers and directors, schedule of key man life insurance policies and organizational charts.

Operational documents, including practice business plans, brochures, price lists, catalogs and other product information, sales forecasts, data on customers and suppliers, and capital budgets.

Reports of other professionals, including appraisals on specific assets and reports by other consultants.

Other internal information, including documents or details relating to potential public offerings for debt or equity, venture capital prospectus or similar information, and tracking of incurred but not reported (IBNR) expenses.

  • Loan Agreements

The medical practice may have loaned or borrowed funds from affiliates. Such loan arrangements may require adjustments to be made to the economic value of the subject entity.

Uncollectible loans receivable should have been written off.

Collectible loans receivable may still be considered non-operating assets and evaluated separately.

Loans payable to related parties may be structured as demand notes, but there may be little chance that such loans will be repaid. Such loans may be considered either long-term debt or a form of owners’ equity.

B. Site Visit / Interview Information

The following types of information specific to the medical practice should be gathered by the financial executive or healthcare consultant. This information may be obtained through an interview, questionnaire, or preferably a site visit.

Valuation

  • Background Information

Include such information as the number of years the entity has operated at its current location and in the community, as well as the office hours.

  • Building Description

Include the location (urban/suburban), proximity to hospitals and other medical facilities, and its size, construction, electrical and computer wiring, age, access to parking, and so on.

  • Office Description

Approximate acquisition details and price, as well as ownership or lease details should be included.  The square footage and number of rooms, and a description of different office areas should be outlined, including, where applicable: medical equipment, including all diagnostic imaging and major medical equipment; pharmacy, laboratory, examination rooms, waiting rooms, and other areas.

  • Management Information Systems

Document types of hardware and software and the cost, age, and suitability of all components, including their management functions, reporting capabilities, and integration between programs.

  • History of the Practice Entity

Give the date founded and by whom, the number of full-time equivalent (FTE) physicians in practice by year, the physicians who have joined and left the entity, the dates they practiced at the entity, and their relationship and practice arrangement with the entity.

  • Office Staff Description

Include the number and types of non-physician positions as well as the tenure and salary of all current employees.

  • Competitive Analysis

Include details of hospital programs impacting practice, growth or decline in the volume of business and the reasons, association with other physicians, competitive strengths and threats, the number and volume of procedures performed, any change in the number and volume, and the corresponding fees.

  • Patient Base Information

Encompass income distribution and percentages from different payors, the number of new patients and total patients seen per week, the age mix of patients, the number of hours spent in patient care per week, and the number of surgeries performed.

  • Managed Care Environment

Detail the terms and conditions of all managed care contracts including discounts and withholds, the impact on referral patterns and revenues, willingness to participate in risk sharing contracts and capitation, and the entity’s managed care reporting capabilities.

  • Hospital Privileges and Facilities

List all hospital privileges held by physician members of the medical practice and the requirements for acquiring privileges at the different local hospitals.

  • Credit Policy and Collections

Include practice policies for billing and payment, use of collection agencies, acceptance of assignments, other sources of revenues, and an aged breakdown of accounts receivable.

  • Financial Management

Include cash management procedures and protections, credit lines and interest, controls to improve payment of accounts payable, late payment frequency, formal or informal financial planning methods, and budgeting processes.

  • Operational Assessment Include governance structure for the entity, detailing responsibilities and procedures for performance, conflicts, recruitment, outcomes measures, case management, reimbursement, income, continuing medical education (CME), credentialing, and utilization review.

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Assessment

Allow for discussion of overall relationships with physicians in the community, practice concerns, and needs.

Source: “Research and Financial Benchmarking in the Healthcare Industry”

By Robert James Cimasi; MHA, ASA, CBA. AVA, CM&AA, CMP™
By Todd A. Zigrang; MHA, MBA, CHE
By Anne P. Sharamitaro; Esq

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. What did we forget and what is your experience? Why did you need a medical practice valuation?

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

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FINANCE: Financial Planning for Physicians and Advisorsation?

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Video on Hedge Fund Manager Michael Burry MD

In The Subprime of His Life – My Story

By Dr. David Edward Marcinko MBA, CMP™

[Editor-in-Chief]

I am a long time fan of financial industry journalist Michael Lewis [Liars’ Poker, Moneyball and others] who just released a new book. The Big Short is a chronicle of four players in the subprime mortgage market who had the foresight [and testosterone] to short the diciest mortgage deals: Steve Eisner of FrontPoint, Greg Lippmann at Deutsche Bank, the three partners at Cornwall Capital, and most indelibly, Wall Street outsider Michael Burry of Scion Capital. They all walked away from the disaster with pockets full of money and reputations as geniuses.

About Mike

Now, I do not know the first three folks, but I do know a little something about my colleague Michael Burry MD; he is indeed a very smart guy. Mike is a nice guy too, who also has a natural writing style that I envy [just request and read his quarterly reports for a stylized sample]. He gave me encouragement and insight early in my career transformation – from doctor to “other”.  And, he confirmed my disdain for the traditional financial services [retail sales] industry, Wall Street and their registered representatives and ‘training’ system, and sad broker-dealer ethos [suitability versus fiduciary accountability] despite being a hedge fund manager himself. I mentioned him in my book: “Insurance and Risk Management Strategies” [For Physicians and their Advisors].

http://www.amazon.com/Insurance-Management-Strategies-Physicians-Advisors/dp/0763733423/ref=sr_1_2?ie=UTF8&s=books&qid=1269254153&sr=1-2

He ultimately helped me eschew financial services organizations, “certifications”, “designations” and ”colleges”, and their related SEO rules, SEC regulations and policy wonks; and above all to go with my gut … and go it alone!

And so, I rejected my certified financial planner [marketing] designation status as useless for me, and launched the www.CertifiedMedicalPlanner.com on-line educational program for physician focused financial advisors and management consultants interested in the healthcare space.

And I thank Mike for the collegial good will. By the way, Mike is not a CPA, nor does he posses an MBA or related advanced degree or designation. He is not a middle-man FA. He is a physician. Unlike far too many other industry “financial advisors” he is not a lemming. IOW: We are not salesman. We are out-of-the-box thinkers, innovators and contrarians by nature. www.MedicalBusinessAdvisors.com

From a Book Review

According to book reviewer Michael Osinski, writing in the March 22-29 issue of Businessweek.com, Lewis is at his best working with characters and Burry is rendered most vividly.

A loner from a young age, in part because he has a glass eye that made it difficult to look people in the face, Burry excelled at topics that required intense and isolated concentration. Originally, investing was just a hobby while he pursued a career in medicine. As a resident neurosurgeon at Stanford Hospital in the late 1990s, Burry often stayed up half the night typing his ideas onto a message board. Unbeknownst to him, professional money managers began to read and profit from his freely dispensed insight, and a hedge fund eventually offered him $1 million for a quarter of his investment firm, which consisted of a few thousand dollars from his parents and siblings. Another fund later sent him $10 million”.

“Burry’s obsession with finding undervalued companies eventually led him to realize that his own home in San Jose, Calif., was grossly overpriced, along with houses all over the country. He wrote to a friend: “A large portion of the current [housing] demand at current prices would disappear if only people became convinced that prices weren’t rising. The collateral damage is likely to be orders of magnitude worse than anyone now considers.” This was in 2003.

“Through exhaustive research, Burry understood that subprime mortgages would be the fuse and that the bonds based on these mortgages would start to blow up within as little as two years, when the original “teaser” rates expired. But Burry did something that separated him from all the other housing bears—he found an efficient way to short the market by persuading Goldman Sachs (GS) to sell him a CDS against subprime deals he saw as doomed. A unique feature of these swaps was that he did not have to own the asset to insure it, and over time, the trade in these contracts overwhelmed the actual market in the underlying bonds”.

“By June 2005, Goldman was writing Burry CDS contracts in $100 million lots, “insane” amounts, according to Burry. In November, Lippmann contacted Burry and tried to buy back billions of dollars of swaps that his bank had sold. Lippmann had noticed a growing wave of subprime defaults showing up in monthly remittance reports and wanted to protect Deutsche Bank from potentially massive losses. All it would take to cause major pain, Lippmann and his analysts deduced, was a halt in price appreciation for homes. An actual fall in prices would bring a catastrophe. By that time, Burry was sure he held winning tickets; he politely declined Lippmann’s offer”

And the rest, as they say, is history.

Link: http://www.businessweek.com/magazine/content/10_12/b4171094664065.htm

My Story … Being a Bit like Mike

I first contacted Mike, by phone and email, more than a decade ago. His hedge fund, Scion Capital, had no employees at the time and he outsourced most of the front and back office activities to concentrate on position selection and management. Early investors were relatives and a few physicians and professors from his medical residency days. Asset gathering was a slosh, indeed. And, in a phone conversation, I remember him confirming my impressions that doctors were not particularly astute investors. For him, they generally had sparse funds to invest as SEC “accredited investors” and were better suited for emerging tax advantaged mutual funds. ETFs were not significantly on the radar screen, back then, and index funds were considered unglamorous. No, his target hedge-fund audience was Silicon Valley. And, much like his value-hero Warren Buffett [also a Ben Graham and David Dodd devotee], his start while from the doctor space, did not derive its success because of them.

Moreover, like me, he lionized the terms “value investing”, “margin of safety” and “intrinsic value”.

Co-incidentally, as a champion of the visually impaired, I was referred to him by author, attorney and blogger Jay Adkisson www.jayadkisson.com Jay is an avid private pilot having earned his private pilot’s license after losing an eye to cancer.

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Mike again re-entered my cognitive space while doing research for the first edition of our successful print book: “Financial Planning Handbook for Physicians and Advisors” and while searching for physicians who left medicine for alternate careers!

In fact, he wrote the chapter on hedge funds in our print journal and thru the third book edition before becoming too successful for such mundane stuff. We are now in our fourth edition, with a fifth in progress once the Obama administration stuff [healthcare and financial services industry “reform” and new tax laws] has been resolved

http://www.amazon.com/Financial-Planning-Handbook-Physicians-Advisors/dp/0763745790/ref=sr_1_1?ie=UTF8&s=books&qid=1269211056&sr=1-1

Assessment

News: Dr. Burry appeared on 60 Minutes Sunday March 14th, 2010. His activities with Scion Capital are portrayed in Michael Lewis’s newest book, The Big Short.
An excerpt is available in the April 2010 issue of Vanity Fair magazine, and at VanityFair.com 

Video of Dr. Burry: http://www.cbsnews.com/video/watch/?id=6298040n&tag=contentBody;housing

Video of Dr. Burry: http://www.cbsnews.com/video/watch/?id=6298038n&tag=contentBody;housing

PS: Michael Osinski retired from Wall Street and now runs Widow’s Hole Oyster Co. in Greenport, NY http://www.widowsholeoysters.com

And, our www.MedicalBusinessAdvisors.com related books can be reviewed here: http://www.amazon.com/s/ref=nb_sb_noss?url=search-alias%3Dstripbooks&field-keywords=david+marcinko

Assessment

Visit Scion Capital LLC and tell us what you think http://www.scioncapital.com.

And to Mike himself, I say “Mazel Tov” and congratulations? I am sure you will be a good and faithful steward. The greatest legacy one can have is in how they treated the “little people.” You are a champ. Call me – let’s do lunch. And, I am still writing: www.BusinessofMedicalPractice.com for the conjoined space we both LOVE.

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

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Healthcare Case Models CD-ROM

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Office Case Models in Healthcare Business 

[A Practice Improvement Compendium]

In Medical Practice? – Buy this CD-ROM

Regardless of specialty, most doctors quickly realize there are few case model guidelines available to steer them through the day-to-day management maze. One solution is to discuss best-of-breed practices with leading practitioners in order to discern what successful doctors are doing [mentoring concept].

The Problem

Of course, this is a costly and time consuming process with no criteria for success. Today, mentors are even loath to assist as competitive advantage can be lost.

A Solution

A better solution may be to use our Case Models in Healthcare [A Practice Improvement Compendium] to appreciate real-world practice situations and develop personalized approaches for an appropriate course of action. These techniques are so powerful that many business schools center their teaching on them. Case studies have been used for one hundred years because of their practical descriptions of actual situations.

Typically, information is presented about a practice’s patients, markets, competition, financial structure, service volumes, management, employees and other factors affecting success. The length of a case study may range from a few pages to 30, or more. And, our Case Models in Healthcare [A Practice Improvement Compendium] is suitable for medical practices, clinics, hospitals and other emerging healthcare entities.

We use three different methods to enhance your knowledge and launch your practice’s success: 

  • Prepared case-specific questions, with detailed answers, to illustrate underlying practice management concepts.
  • Problem-solving analysis, styled after Harvard Business School, to learn intuitive skills for resolving various practice issues.
  • A “no-answer” strategic planning approach to develop your ability to analyze a complex situation, generate a variety of possible strategies, and select the “best” from multiple self-generated solutions. 

 Case Model Topics

We give you more than 25 healthcare administration cases, covering the enterprise wide practice management ecosystem, to champion your financial success: 

  1. Market Competition
  2. Operations Management
  3. Capital Formation
  4. Cash Flow Management
  5. Revenue Analysis
  6. Hybrid Costing
  7. OSHA Model
  8. Economic Order Quantity Costing
  9. USA Patriot Act
  10. Mixed Costing
  11. Managerial Accounting
  12. Cost Volume Profit Analysis
  13. Insurance Contract Analysis
  14. Incurred but Not Reported Claims
  15. Accounts Receivable
  16. Cost Accounting
  17. Medical Contract Negotiations
  18. Workplace Violence
  19. HIPAA
  20. Sarbanes-Oxley Act
  21. Medicare Compliance
  22. Health Information Technology
  23. IRS Form 990
  24. Hospital Valuations
  25. HIT Security
  26. Medical Endowment Funds; and others.

 Bonus Features

 We also include at no additional charge: 

1. Glossary of Insurance and Managed Care

2. Glossary of Health Economics and Finance

3. Glossary of Health IT and Security

To help avoid administrative worries, you need Case Models in Healthcare [A Practice Improvement Compendium].

Sample Case Model: WV 1 

Promo Letter: Letterhead Case Models Compendium

Testimonial:

“I thought about going back to business school to enhance my practice management knowledge – but now I have these case models that help solve many office problems and assist in difficult administrative situations.”  [Dr. Michael Lampkin, MD] 

Product Specifications: Adobe Acrobat Reader® required – both Mac and PC compatible. And, the handsome, sturdy package makes the CD-ROM an ideal gift for the recent graduate, mid-career doctor or mature medical practitioner; office manager, CXO or healthcare administrator.

TO ORDER: Please send your check or money order [for the CD] to: iMBA Inc, Suite #5901 Wilbanks Drive, Norcross, GA 30092-1141 [770.448.0769] or MarcinkoAdvisors@msn.com

OR - you may order electronically right here: www.e-junkie.com/ecom/gb.php?c=cart&i=641934&cl=109140&ejc=2

Only: $ 99.00 USD [includes SPH & tax]. 

Health 2.0 Empowers Patients – Worries Doctors

Patient 2.0 Collaborative Care Worries Doctors

By Staff Reporters

Writing for Time, Bonnie Rochman digs into the ramifications of patients sharing information and tips online, an “empowerment movement” she calls “Patient 2.0.”

Society of Participatory Medicine

In the piece, she profiles the newly created Society for Participatory Medicine, which “encourages patients to learn as much as they can about their health and also helps doctors support patients on this data-intensive quest,” as well as PatientsLikeMe.com, a free service which makes its money by selling anonymized patient information.

Assessment

Link: http://www.healthjournalism.org/blog/2010/02/patient-20-empowers-patients-worries-doctors/

Our New Book

For more information, please visit our new companion blog for the: Business of Medical Practice [Transformational Health 2.0 Profit Maximizing Skills for Savvy Doctors] – third edition.

Link: www.BusinessofMedicalPractice.com

Conclusion

And so, your comments on this ME-P are appreciated. What are your thoughts on health 2.0? Are doctors worried? Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com 

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Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Subscribe Now: Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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Sponsors Welcomed

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Dr. Somnath Basu on Investing

Writes for the Medical Executive-Post

By Ann Miller; RN, MHA

[Executive-Director]

Dr. Somnath Basu is no stranger to the ME-P, or the financial planning community. He is a Professor of Finance at California Lutheran University and the Director of its California Institute of Finance.

Academic Background

Dr Basu earned his BA in Economics, University of Delhi, MBA (Finance), Marquette University and a PhD (Finance), University of Arizona. He is well published and is an award winning teacher. He has significant consulting experience with US Fortune 100 companies, advising institutional money managers and in developing proprietary finance and planning software. He serves on various Boards and committees including the CFP (chaired the Model Curriculum Revision Committee) Board of Standards and the Financial Planning Association.

Basu’s New Book

His new book, co-authored with Professors’ Block and Hirt, Investment Planning for Financial Professionals is available now, published by McGraw Hill, in May 2006.

Link: http://www.amazon.com/Investment-Planning-Geoffrey-Hirt/dp/0071437215/ref=sr_1_1?ie=UTF8&s=books&qid=1265918999&sr=1-1

Additional essays by Dr. Basu can be viewed at: http://blog.fpaforfinancialplanning.org/author/somnathbasufpa/

He also writers a column for the Journal of Financial Services Professionals. He can be reached at:

Contact Dr. Somnath Basu
Director – California Institute of Finance
Cell: 805 405 4448
Work: 805 493 3980
http://www.clunet.edu/cif

Conclusion

And so, feel free to begin a conversation with Somnath Basu PhD. We are sure he appreciates your thoughts and comments on his work.

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Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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Seeking Patient 2.0 and Health 2.0 Definitional Stability

What is it – How does it work?

By Hope Rachel Hetico; RN, MHA

[Managing Editor]

The Internet is a constantly evolving service that continues to grow at an exponential rate, despite late adoption by some physician practices. 

History

Since 1995, the primary use of the internet was e-mail communications with peers, hospitals and others. 

Next providers linked to hospitals and managed care organizations to obtain more direct connectivity for clinical information and insurance benefits coverage.

More recently, physicians are finding other beneficial avenues to expand their utilization of the Internet:     

  • Direct e-mail inquiries from patients.
  • Patient educational newsletters and links to other educational sites.
  • Continuing medical education (CME).
  • Chat room, consultations, conferences or professional presentations.
  • Nurse to patient e-mail connectivity.
  • Immediate data on lab results with alerts for abnormal high or low values.
  • CPOEs (Computerized Purchase Order Entry Systems).
  • Radiology images.
  • Appointment scheduling patient reminders.
  • HIPAA compliant Application Service Providers (ASP) for dictation, recording, routing and speech recognition and transcription services.
  • eMR (Electronic Medical Records) and clinical medical group ware, etc.

Health 2.0, Web 2.0 and Patient 2.0

But, ever since the term “web 2.0″ was first used in 2004, there has been an inordinate amount of chatter about what web 2.0 really is and its true impact in medicine. No one’s defined it clearly, but we think the web evolution relative to healthcare essentially falls into 3 generations, as outlined in the new re-source: Dictionary of Health Information Technology www.HealthDictionarySeries.com and our related websites, wikis and professional blogs www.BusinessofMedicalPractice.com

Health 2.0 Journalists

According to healthcare visionary and uber-blogger Matthew Holt, http://www.health2advisors.com and similar other sources, Healthcare 2.0 may be defined as:

“A rapidly developing and powerful new business approach in the health care industry that uses the Web to collect, refine and share information. It is transforming how patients, professionals, and organizations interact with each other and the larger health system. The foundation of healthcare 2.0 is information exchange plus technology. It employs user-generated content, social networks and decision support tools to address the problems of inaccessible, fragmentary or unusable health care information. Healthcare 2.0 connects users to new kinds of information, fundamentally changing the consumer experience (e.g., buying insurance or deciding on/managing treatment), clinical decision-making (e.g., risk identification or use of best practices) and business processes (e.g., supply-chain management or business analytics)”.

And so, if Health 1.0 was a book, Health 2.0 is a live discussion.

Furthermore, Scott Shreeve, MD – http://blog.crossoverhealth.com [personal communication] of Cross-Over Health defines health 2.0 as:

 “A New concept of healthcare wherein all the constituents (patients, physicians, providers, and payers) focus on healthcare value (outcomes/price) and use competition at the medical condition level over the full cycle of care as the catalyst for improving the safety, efficiency, and quality of health care.”

Assessment

By now, you probably realize that Health 2.0 empowers patients and worries doctors.

Writing for Time magazine recently, journalist Bonnie Rochman explored the ramifications of patients sharing information and tips online, an “empowerment movement” that she calls “Patient 2.0.”

In her piece, she profiled the newly created Society for Participatory Medicine, which “encourages patients to learn as much as they can about their health and also helps doctors support patients on this data-intensive quest,” as well as  www.PatientsLikeMe.com, a free service which makes its money by selling anonymized patient information.

Source: http://www.healthjournalism.org/blog/2010/02/patient-20-empowers-patients-worries-doctors

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Conclusion

And so, your comments on this ME-P are appreciated. Do doctors really fear Health 2.0? What do Health 2.0 and Patient 2.0 mean to you? How would you define the terms formally, and how do you use Web 2.0 in your medical practice? Or, are you a late-adopter still waiting for governmental or CCHIT definitional clarity?

Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com 

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Our Other Print Books and Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Subscribe Now: Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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Sponsors Welcomed

And, credible sponsors and like-minded advertisers are always welcomed.

Link: http://healthcarefinancials.wordpress.com/2007/11/11/advertise

Dr. Atul Gawande’s “Checklist Manifesto” and Book Review

Healthcare Reform’s Rock Star -or- Much Needed Plain Speaker?

By Hope Rachel Hetico; RN, MHA, CMP™

[Managing Editor]

Here is an essay-interview by Rahul K. Parikh MD, with Atul Gawande MD, as they talk about medicine, checklists and quality healthcare.

Book Review

In Gawande’s third book, “The Checklist Manifesto: How to Get Things Right,” he explores how doctors and other professionals become overwhelmed with the complexity of their work. And, are then more likely to fail.

As with most problems that sound overwhelmingly complex, the fix may be quite easy, when reframed with a new mindset and fresh set of young eyes.

Assessment

Gawande’s proposed solution is simple and inexpensive, if not terribly sexy: a checklist. Sound too mundane? Keep in mind that Gawande has previously proved, in conjunction with the World Health Organization [WHO], that doctors and surgical teams who use checklists save lives.

Link: http://www.salon.com/books/int/2010/02/02/atul_gawande_checklist/index.html

Conclusion

And so, your thoughts and comments on this ME-P are appreciated.

Is Atul this generation’s healthcare quality guru, much like Robert Wachter MD. Or, is he a man-child not afraid to say that the Emperor has no clothes? Please opine.

Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com 

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Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

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Will eMRs Raise the Legal Standard of Care and Increase Malpractice Risk?

Focus on Malpractice and Professional Liability

By Ann Miller; RN, MHA

[Executive Director]

We first postulated on this topic in our print book “Insurance Planning and Risk Management for Physicians and their Advisors.” Additional posts and comments are contained within this ME-P.

And now, Robert J. Mintz, JD wonders if medical provider liability increases with eHRs, even if the quality of care is vastly improved?

Related External Posts

Assessment

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Conclusion

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Important Financial Documents for Physicians

A Simple Pro-Active List

By Staff Reporters

www.HealthcareFinancials.com 

Document Status   Location
 
Will, original      
 
Will, copy      
 
Living Will      
 
Power of Attorney      
 
Birth Certificate      
 
Marriage Certificate      
 
Antenuptial Agreements      
 
Postnuptial Agreements      
 
Divorce Decrees      
 
Separation Agreement      
 
Social Security Card      
 
Income Tax Records      
 
Life Insurance Policies      
 
Other Insurance Policies      
 
Stocks and Bonds      
 
Notes Receivable      
 
Mortgages Receivable      
 
Deeds      
 
Leases      
 
Bank and Financial  
Records      
 
Business Agreements      
 
Trust Instruments      

Assessment

What did we miss, please advise?

 

 

Conclusion

Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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Our Other Print Books and Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Subscribe Now: Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Sponsors Welcomed

And, credible sponsors and like-minded advertisers are always welcomed.

Link: http://healthcarefinancials.wordpress.com/2007/11/11/advertise

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